Where were you when it happened?

Thursday 14th April, 2016. 1pm.

Where were you when it happened?

I was in the office, hiding from the rest of the workers and taking a quiet moment in the chief executive’s swivel chair to watch history being made. My father rang from his car to tell me that he’d heard them mention it on BBC Radio 5. Across the globe, people tweeted images of themselves sitting in lecture theatres, standing on the side of the road, and staring slack-jawed at their laptops as Mr Shafi Ahmed, (@ShafiAhmed5) Consultant Colorectal Surgeon at the Royal London Hospital, broke new ground with the world’s first live-streamed operation in Virtual Reality.

Shafi Ahmed, Virtual Surgeon

I had the pleasure of meeting Shafi back at the Wearable show in March, 2014, where he was exhibiting VR & Augmented Reality (AR) healthcare applications with Amplified Robot. Since then I’ve met him on a few occasions, and each time I’ve left with a mind expanded several sizes larger than when I arrived. He’s a true believer in the transformative and democratic power of Digital Healthcare, particularly when it comes to medical education and reaching out to the less well served parts of the globe.

Shafi is a man for firsts, having also been the first to use Google Glass live-stream an operation from a first person point-of-view (joining other innovators such as Dr Rafael Grossman (@zjgr) , US surgeon who first transmitted live surgical footage in this way back in June 2013). His office is a treasure trove of medical gadgetry. He’s even been known to sweep in for his lectures on hoverboard.

The event itself has been advertised for the last few weeks, slowly gaining media attention. The Virtual Surgeon platform, developed by Medical Realities in association with Mativision and Amplified Robot, was available as a free download on Google Cardboard, Samsung Gear VR, and Oculus Rift. You could even watch in it a browser, should the thought of viewing the procedure first hand in VR feel too overwhelming.

The clock rolled past the start time as I sat alone in the office finishing off the remains of my cup of tea. Nothing happened. I clicked the logo several times, to be treated to the soundless preview footage on a loop. Things weren’t looking good, and somewhere I imagined a pall of smoke rising above an over-heating webserver. I took to twitter but was pleased to see that more mundane, real-world and (lets face it) more important concerns were delaying things slightly – the patient was being made ready.

Courtesy of @IAmMobileBob

All of a sudden, it started. I was there, in the operating theatre, and I was transfixed as Mr Ahmed began the laparoscopic procedure, calmly talking us through the steps he was taking to first reduce a hernia, before proceeding to the tumour resection. The stream was a little grainy, much as any of the streamed VR footage I have seen already, but the audio was clear and the sense of immersion was striking. On both sides of the operating table large screens relayed the operating field, and around Shafi the team worked smoothly as the well drilled unit they clearly are. Thinking back to my time as a medical student and junior doctor, the only thing that was missing was an anaesthetist quietly completing a the Telegraph crossword, while the lead surgeon screamed at me for not knowing the branches of the Mesenteric artery. Oh, and that smell.

All too soon the real world intruded on the virtual, and I had to return to work. I took the opportunity to introduce some co-workers to VR in the most immediate and graphic way, and I was done.

What an introduction – first time in VR and he watches an operation livestreamed!

It’s now a few hours after the broadcast and I’ve had time to think about what I saw and what it meant. I’d love to see the stream in a higher resolution, but this is simply a matter of time and product development. Likewise, I’d have loved some binaural audio. It would have been great to have the laparoscope feed overlaid to the side so I could have had a better view. I’d also have loved it if the assisting surgeons hand hadn’t loomed enormously into view as the patient was repositioned but this was primarily about the patient, so I’ll forgive him that.

Twitter reacts to #VRinOR

I can wax hyperbolic about the possibilities for making surgical training globally accessible, but the most incredible thing about today was that here was a currently available technology, delivered cheaply to a huge global audience, by a bold innovator with a passion for education and adventure. That Daniel Kraft ( @daniel_kraft) , Medical & Neuroscience chair of the Singularity University, had also made the trip to watch this live, while the a news crew stood filming from a safe distance, showed the significance of today’s event. We had the rock star, the press, and leading the show with a tremendous vision of the future was our own Tony Stark: Mr Shafi Ahmed.

I tried to log on when I woke up this morning but unfortunately I think that pall of smoke had taken hold by that stage. Fantastic achievement none the less. I sometimes forget the awe that surgery can inspire. (I’m usually the one with the proverbial telegraph in the corner).